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A little over one year ago, my organization transitioned from one form of health information technology to an upgraded health information technology. The transition was from a paperless charting system to a fully functional paperless system, including physician ordering. This task was to be completed in regard to the government’s involvement with meaningful use, and reimbursement for Medicare and Medicaid patients who are prevalent in the rural area I work in. All in all, the financial incentive was a driving factor, but my facility recognized that by implementing this new system we could improve the care and overall wellbeing of our patients. We could assist as well in tracking vital statistics that could be applied for research and best practice implementation. It was truly a winning situation for everyone!
From a nursing standpoint, the transition was demanding, because anything new is demanding in the midst of taking care of sick human beings. However, since we had already been utilizing computerized charting for patient charting and medication administration, the toughest task was figuring out the geographies of the new system. Through support of peers and change leaders, the task was successfully launched and now off and running. The government tasked organizations with being up and running to meet certain goals by certain dates. These dates were set in three sections, and I am proud to say that by the deadline of each event, we were at the mark expected. As of recent, we met our third deadline with success! At this point we are now modifying and fixing problems as we encounter them. We are far from mastering this new system, but we have come leaps and bounds since day one.
Management of Change
My facility utilizes a Line model business system. The order generally come from the top down. We are very fortunate to have a leadership who is educated, and has foresight. They are well versed and believe strongly in proactive planning and management rather than reactive management. Proactive planning takes into account the organizations past, present and future. This allows for the group to plan for the future, rather than reacting to it (Marquis & Huston, 2015, p. 143).
Proactive planning still takes preparation, adoption and implementation. This can only occur by leaders bridging and meeting needs by compromise between higher level decision makers and the staff carrying out daily duties (Laureate Education, 2012). It is important to find champions for change, from all departments involved. The champions need to be able to see the change vision, the positive yield it carries, and then have these people lead the way for change (Marquis & Huston, 2015). Even with the best of leaders, there needs to be a formal planned change theory. The choice of most facilities is Lewins Theory of Planned Change.
There are three simple steps which are unfreezing, movement, and refreezing. Unfreezing requires recognizing the problem and making a start of changing normal practices. “The movement stage necessitates creating a detailed plan of action and engaging people to try out the proposed change. Often, this stage is difficult because it has uncertainty and fear associated with change” (Shirey, 2013, p. 70). This stage involves training to overcome fears and clear communication to avoid losing sight of the desired target, which is a new and improved reality. Finally is the last stage of refreezing which is simply making the change sustainable, and making it the new way of everyday practice.
The Change Process
My organization did a wonderful job in the change process. They supplied change agents from all levels of authority, as well as all department specialties. There was ample time for preparation as well as trial implementation before the overall go live day. Finally, during the training and go live days ahead, there was change leaders present in all departments, in all shifts to make certain that all questions and concerns were answered and addressed.
Laureate Education, Inc. (2012). Organizational dynamics: Planned change and project planning. [Video file]. Retrieved from https://class.waldenu.edu/webapps/blackboard/content/listContent.jsp?course_id=_11196748_1&content_id=_28628444_1
Marquis, B. L., & Huston, C. J. (2015). Leadership Roles and Management Functions in Nursing (8th ed.). Philadelphia, PA: Waltors Kluwer Health/ Lippincott
Shirey, M. (2013, February). Lewins Theory of Planned Change as a Strategic Resource. The Journal of Nursing Administration, 43(2), 69-72. http://dx.doi.org/10.1097/NNA.0b013e31827f20a9
A Change in Healthcare Organization
One of the fastest change that occurred in healthcare system is the introduction of technology by advancing to computer charting, patients scanning, and so on. Every aspect of healthcare has been computerized in order to adjust with the advanced technology and provide safe patient care. The latest change that occurred in my facility is scanning arm band. Although charting and the scheduled medications were computerized, nurses did not have to scan patients arm band in order to administer medication. It has been reported that technology usage have significantly contribute in the reductions in potential medication administration errors after the implementation of scanning systems (FitzHenry et al, 2011).
The Impact of Change
The old fashion of patients’ identification was unsafe and risky. Therefore, with the introduction of Evidence Base Practice and the fast growing of advanced computerized healthcare, the organization had to abide by measures to maintain patient safety a priority (Mitchell, 2013). This change created conflict, noncompliance, and resistance among staff; therefore, continuous education had to be implemented in order to facilitate the change. Evidently, the purpose of this change to electronical scanning is to avoid medical error and advocate for patients safety. Strategies for planning and implementing change to electronically scan patients and medication prior to medication admiration is a method to decrease medications errors and promote safety in the organization (FitzHenry et al, 2011). Just like any change, the transition was challenging for staff members; therefore strict measures had to be implemented to maintain compliance and enhance staffs teaching.
The Effectiveness of the change
To plan such change requires team work and collaboration with the entire departments of the organization in order to maintain compliance, enhance the transition, and achieved the goal implemented. It has been emphasis that in order for a plan to be effective, nurse managers must identify short and long term goals and implement strategies needed to ensure the unit goal for change to be meet (Marquis & Huston, 2015). Since changes naturally comes with challenges, it is necessary for leadership vision and creativity to be implemented in order for staff to comply with plan because planning requires flexibility, training, enthusiasms, and energy. In order for healthcare organization to thrive and maintain a successful facility, it would have to keep up with the increase changes in healthcare system (Shirey, 2013). The introduction of evidence base practice has redefine nursing practice and outline policies and procedures that regulate the healthcare system (Mitchell, 2013).
Management of Change
Just like any other challenge nurses encounter, the introduction of patient scanner is one of the many changes they have to adjust with. The American Organization of Nurse Executives identifies communication, knowledge, leadership, professionalism, and business skills to execute competency during a period of transition (Shirey, 2013). Change in healthcare always come with challenges, but management play an important role in minimizing conflict while balancing stability between new technology and old customs.
Progress of Change
Nursing leadership is required in order to execute and demonstrate expertise with change planning. Most often, successful change initiatives use change theory which identify the need for change, and mobilizing others to see the need for change in order to implement organizational goals (Mitchell, 2013). The experience was very successful and all staff now use the scanner prior to administer medication because staff have realized that scanning is not just for patients’ safety, but it keeps them from making errors. The change to new technology was challenging, but essential for patients’ safety. Nursing leadership role to enhance the transition, balance the differences, and resolve conflict was fundamental in the implementation of new technology
FitzHenry, F., Doran, J., Lobo, B., Sullivan, T. M., Potts, A., Feldott, C. C., & … Doulis, J. (2011). Medication-error alerts for warfarin orders detected by a bar-code-assisted
medication administration system. American Journal Of Health-System Pharmacy, 68(5), 434-441. doi:10.2146/ajhp090666
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management – UK, 20(1), 32-37
Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2), 69-72. doi:10.1097/NNA.0b013e31827f20a9